Objective
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is primarily clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder.
Methods
A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the PICO (Population, Intervention, Comparator, and Outcome) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework.
Results
Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and not as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilatation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Citations

• Comparison of efficacy of intra-articular injection of platelet-rich plasma with bupivacaine and steroid combination in chronic shoulder pain
  Naveen Malhotra, Neha Sinha, Amit Kumar, Ritu, Disha Gupta, Naman Malhotra
  Journal of Anaesthesiology Clinical Pharmacology.2026; 42(1): 120.     CrossRef

Objective
To test the hypothesis that a longer duration of phase II cardiac rehabilitation is required to recover the exercise capacity of elderly patients compared to younger patients.
Methods
We retrospectively reviewed and analyzed the medical records of patients who were referred to our cardiac rehabilitation (CR) center and underwent percutaneous coronary intervention for acute myocardial infarction (AMI). A total of 70 patients were enrolled who underwent an exercise tolerance test (ETT) 3 weeks after the occurrence of an AMI (T0), 6 weeks after the first ETT (T1), and 12 weeks after the first ETT (T2). Patients older than 65 years were assigned to the elderly group (n=24) and those aged 65 years and younger to the younger group (n=46). Both groups performed center-based or home-based CR for 12 weeks (3 times per week and 1 session per day). Exercise intensity for each individual was based on the target heart rate calculated by the Karvonen formula. The change in maximal metabolic equivalents (MET_max) of the two groups was measured at each assessment point (T0, T1, and T2) to investigate the recovery of exercise capacity.
Results
The younger group showed improvement in MET_max between T0 and T1. However, MET_max of the elderly group showed no significant improvement between T0 and T1. The exercise capacity, measured with MET_max, of all groups showed improvement between T0 and T2.
Conclusion
Elderly patients with AMI need a longer duration of CR (>6 weeks) than younger patients with AMI.

Citations

• Advancements, challenges, and innovative strategies in cardiac rehabilitation for patients with acute myocardial infarction: A systematic review
  Sisheng Zhang, Yuhui Lin
  Current Problems in Cardiology.2025; 50(2): 102934.     CrossRef
• L’unité de gériatrie aiguë à orientation cardio-gériatrique : une innovation pour la prise en charge des patients âgés
  Amaury Broussier, Nina Liu, Nathalie Marie-Nelly, Émilie Thomas, Livia Labon, Gita Motamed
  Soins.2025; 70(895): 50.     CrossRef
• Effect of Combined Exercise Training on Physical and Cognitive Function in Women With Type 2 Diabetes
  Nafiseh Ghodrati, Amir Hossein Haghighi, Seyed Alireza Hosseini Kakhak, Sadegh Abbasian, Gary S. Goldfield
  Canadian Journal of Diabetes.2023; 47(2): 162.     CrossRef
• The effects of rate pressure product at admission on cardiopulmonary function during hospitalization in patients with acute myocardial infarction
  Chun-Mei Zeng, Yan-Mei Zhao, Yi-Yi Li, Rong-Rong Gan, Zheng Ling, Ping Li
  Postgraduate Medicine.2023; 135(8): 803.     CrossRef
• Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease
  Seong Bok Choi, Ji Hee Kim
  Journal of Multidisciplinary Healthcare.2023; Volume 16: 3309.     CrossRef
• Cardiac Rehabilitation and Complementary Physical Training in Elderly Patients after Acute Coronary Syndrome: A Pilot Study
  Aurelija Beigienė, Daiva Petruševičienė, Vitalija Barasaitė, Raimondas Kubilius, Jūratė Macijauskienė
  Medicina.2021; 57(6): 529.     CrossRef
• Shorter Wait Times to Cardiac Rehabilitation Associated With Greater Exercise Capacity Improvements
  Dion Candelaria, Robert Zecchin, Cate Ferry, Laila Ladak, Sue Randall, Robyn Gallagher
  Journal of Cardiopulmonary Rehabilitation and Prevention.2021; 41(4): 243.     CrossRef
• Predictors for one-year outcomes of cardiorespiratory fitness and cardiovascular risk factor control after cardiac rehabilitation in elderly patients: The EU-CaRE study
  Prisca Eser, Thimo Marcin, Eva Prescott, Leonie F. Prins, Evelien Kolkman, Wendy Bruins, Astrid E. van der Velde, Carlos Peña Gil, Marie-Christine Iliou, Diego Ardissino, Uwe Zeymer, Esther P. Meindersma, Arnoud W. J. Van’tHof, Ed P. de Kluiver, Matthias
  PLOS ONE.2021; 16(8): e0255472.     CrossRef
• Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study
  Sora Baek, Yuncheol Ha, Jaemin Mok, Hee-won Park, Hyo-Rim Son, Mi-Suk Jin
  Annals of Rehabilitation Medicine.2020; 44(6): 481.     CrossRef

Objective
To compare a center-based cardiac rehabilitation (CR) program with a home-based CR program in terms of improving obesity related index and cardiopulmonary exercise capacity after the completing a phase II CR program.
Methods
In this study, there were seventy-four patients with acute myocardial infarction after percutaneous coronary intervention who were analyzed. Patients with mild to moderate risk (ejection fraction >40%) were included in the group. The patients underwent an exercise tolerance test by measurement of the modified Bruce protocol at three assessment points. Those in the center-based CR group participated in a 4-week training program with electrocardiography monitoring of the patient’s progress and results, while those patients who were in the home-based CR group underwent self-exercise training. We measured the obesity related indices such as body mass index, fat free mass index (FFMI), and cardiopulmonary exercise capacity including peak oxygen consumption (VO2max), metabolic equivalents (METs), heart rate, resting systolic blood pressure and the diastolic blood pressure of the participants and noted the results.
Results
Of the 74 patients, 25 and 49 participated in the center-based and home-based CR programs, respectively. Both groups showed significant improvement in VO2max and METs at 1-month and 6-month follow-up. However, FFMI was significantly improved only in the center-based CR group after 1 month of the phase II CR.
Conclusion
Both groups identified in the study showed significant improvement of VO2max and METs at 1-month and 6-month follow-up. However, there was no significant difference in the intergroup analysis. A significant improvement of FFMI was seen only in the center-based CR group after phase II CR.

Citations

• Obesity in Cardiac Rehabilitation: Considerations in Offering Weight Management As Part of Cardiac Rehabilitation Programs
  Codie R. Rouleau, Chelsea Moran, Tamara M. Williamson
  Canadian Journal of Cardiology.2025; 41(12): S33.     CrossRef
• A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study
  Zhen Yang, Yuanhui Sun, Huan Wang, Chunqi Zhang, Aiping Wang
  BMC Nursing.2023;[Epub]     CrossRef
• Center-Based vs Home-Based Geriatric Rehabilitation on Sarcopenia Components: A Systematic Review and Meta-analysis
  Qiaowei Li, Fang Wang, Xiaoqun Liu, Huijuan Zhong, Feng Huang, Pengli Zhu
  Archives of Physical Medicine and Rehabilitation.2022; 103(8): 1663.     CrossRef
• Do Patients Maintain Proper Long-Term Cardiopulmonary Fitness Levels After Cardiac Rehabilitation? A Retrospective Study Using Medical Records
  Chul Kim, Hee Eun Choi, Jin Hyuk Jang, Jun Hyeong Song, Byung-Ok Kim
  Annals of Rehabilitation Medicine.2021; 45(2): 150.     CrossRef
• An observational study substantiating the statistical significance of cardiopulmonary exercise with laboratory tests during the acute and subacute phases of center and home-based cardiac rehabilitation
  Jeong Jae Lee, Jun Young Ko, Seungbok Lee
  Medicine.2021; 100(31): e26861.     CrossRef
• Rehabilitación cardíaca fase 2 post infarto agudo al miocardio.
  Kirby Gutiérrez Arce, Jessy Estefanía Funez Estrada, Cristian Yovany Rojas Aboyte, Perla Lizeth Hernández Cortés Hernández Cortés, María Cristina Enríquez Reyna
  Revista de Ciencias del Ejercicio FOD.2021;[Epub]     CrossRef